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Ask the Doctor hosted by Dr. David Steenblock/June 2018

DR. DAVID STEENBLOCK, D.O
Personalized Regenerative Medicine is about matching therapies and treatments to the individual and their unique biochemical, genetic and other characteristics and features as well as that of their medical challenges. This requires great diagnostic skills as well as a wealth of knowledge, experience, insight and the courage to explore, experiment and innovate in-office (The latter being historically linked to medical progress). These are the very traits, skills and attributes that have characterized Dr. Steenblock and his medical career.

Everything about STEM CELLS we discuss in this article is and should be considered for RESEARCH purposes only!

COPD-STOP THE DETERIORATION AND IMPROVE ACCORDINGLY

Chronic obstructive pulmonary disease (COPD) is a major cause of illness and death globally and treatments that effectively halt progression or reverse the disease or reduce the occurrence and/or severity of exacerbations, are urgently needed. Since this forum is about COPD primarily we will focus our answers on the treatment of COPD (emphysema), chronic bronchitis and bronchiectasis (There conditions occur to some extent simultaneously in almost all cases). The only one of these that can be “cured” is CHRONIC BRONCHITIS if, that is, it has not been allowed to fester for years since over time inflammation will cause irreversible pathological changes in the lungs.

Briefly, inhalant and food allergies can play a major part in chronic bronchitis and the diagnosis and treatment of this by conventional and complementary-alternative therapeutic means should produce significant clinical benefits. The other thing we have found to help is “HIGH ALTITUDE TRAINING” which entails buying or leasing a machine for home use (or paying a doc or other healthcare professional to use it at their office). To use such a machine, you place a mask over your mouth and nose and breathe in mountaintop levels of air (HYPOXIA) for 5 minutes, after which the oxygen level is brought back to your normal for 5 minutes and this cycle of 5 minutes of low levels of oxygen followed by room air is the one hour daily treatment. in many cases these treatments result in the improvement or even cure of bronchitis after 3-4 weeks’ time. If you avoid aggravating your allergies and filter out other irritants during this time this should help as well. For those wanting more information just put the search term “high altitude training” in your search engine.

Moving on, this article reflects a combination of our experience in treating innumerable lung patients, something richly informed by both old and new scientific findings and our own observations of what works and what doesn’t.

We will not discuss the standard medical care of these conditions but urge readers to be under the care of a regular doctor, preferably a pulmonologist.

Most of you with COPD who are members of this discussion forum or who browse it as visitors already know that your lung functioning has been declining over time and you most likely know some of the reasons for this. However, many of you are probably puzzled by the fact their lungs have continued to deteriorate even after stopping smoking or moving away from a highly polluted city or region.

Many people who suffer from lung problems don’t seem to understand that white blood cells are the cause of “PUS” and this shows up in your sputum (phlegm) as a brownish to yellow thick semi-translucent sticky mucous goop. If you have experienced a sore throat once or more often each day this indicates that you have an infection in your head that is draining pus into your lungs which is destroying them and causing you to cough and experience shortness of breath. The longer you wait to be treated for this the more likely it is that the disease in your lungs will progress more quickly than if it was decisively dealt with. The colors of mucus include clear, white, yellow, brown, black, green, and pink or red. Clear means normal, while white indicates congestion and can be a sign of a cold or nasal infection. Yellow and brown shows that an infection is present, while green and black means that the immune system is fighting a serious infection (often Pseudomonas).

There is no reason to think about having any sort of stem cell treatment if any of these symptoms are present. If this describes your situation, call and tell your doctor that you need to be put on antibiotics today! Usually this sort of pus comes from the sinuses (sinusitis) and will require three weeks of antibiotics to get rid of it.

Sinus infections often are not recognized by patients or their doctors which can be disastrous for people with COPD. For those with doubts as to the cause of a nagging cough, ask your doctor to order a CT exam of your sinuses and a CT of your lungs right away (Unless you have had these done in the last 2 years or so). If you do have a sinus infection the radiologist will see the signs of it on the scans.

Also, experience has taught us as physicians that patients should insist on getting copies of all their tests and then should read the reports very carefully. Often doctors tell a person that there is nothing wrong but it is because they did not read the scans or test results carefully or else read them incorrectly. Dr. Haws and I have patients coming to us from all over the USA and the world, many having been seen at major university hospitals and outpatient clinics, with roughly 50% having abnormal lab or scan results that neither they or their families were informed about.

Now a chronic cough can also arise from chronic bronchitis or bronchiectasis both of which are identified by an endoscopic examination of the lungs. If these conditions are the cause of your particular cough you may well have to stay on antibiotics in perpetuity to keep the infection caused inflammation under control, especially if you happen to have bronchiectasis. Thankfully, there are any number of very powerful medical treatments to help ramp down this inflammation but antibiotics most likely will be a mainstay for those suffering from bronchiectasis. Dr. Haws suggests (based on his experience) using bovine colostrum powder (Sovereign Labs, or Numedica) one tablespoon in 4-6 oz of water first thing in the morning and again right before bed for 2 to 3 months starting at the onset of an acute bacterial lung infection. This will not interfere with prescribed antibiotics. Just make sure that the colostrum (also known as proline-rich polypeptides) is taken on an empty stomach and not at same time as the antibiotics NOR WITH PROBIOTICS. Probiotics can be taken in low doses i.e. one capsule three times per day with food but, again, not with colostrum. Later on, after the infectious process is under control (as evidenced by the sputum going clear or white), you may take maintenance doses long-term with no downside consequences. Bovine colostrum powder (PRP – Proline Rich Polypeptides) has 25% to 30% immunoglobulins, growth factors, etc. per standard dose which helps boost a person’s natural immune defenses against lung infection or re-infection (something commonplace in chronic bronchitis or bronchiectasis). Even people allergic or unable to handle lactose milk can usually tolerate bovine colostrum since it is PRE-milk and has different properties than cow’s milk.

Lung patients who drink more water than usual often find this seems to help control the condition better. Taking N-acetylcysteine (NAC) 500 mg 1-3 caps every 6 hours can also help by thinning thick sticky mucous. NAC is also converted into glutathione in the body which is its number one detox agent. Many studies have shown that people with high glutathione levels in their blood are healthier and longer lived than those with low levels. The inhalation of glutathione twice a day by itself is often helpful but may be especially good when combined with the inhalation of stem cells. Inhaled Glutathione may be taken in a nebulizer. Originally, the glutathione is made up by a compounding phamacy and shipped to the user. Inhaled glutathione requires a prescription and is available from compounding pharmacies such as McGuff Compounding Pharmacy and Wellness Pharmacy. The usual starting dose is 200 mg of glutathione (200 mg/cc, draw 1.0 cc with an equal amount of normal sterile saline and place in nebulizer) and inhale that amount twice a day. If well tolerated the dosage can be increased to 1.5 to 2 ml with the same amount of saline. (note from this forum - You can also purchase L-glutathione plus from SeaChange Therapeutics. No prescription is needed. http://www.seachangeforlife.com/Redu...glut121714.htm )

Bronchiectasis (brong-ke-EK-ta-sis) is a condition in which damage to the airways from PUS causes them to widen and become flabby and scarred. This is a condition that develops because of chronic infection irritating and inflaming these vital air tubes. An old remedy that can help rid the lungs of chronic infection is called SSKI which means super saturated potassium iodide. The usual dose of this to try for excess thick secretions is 6 drops in 8 oz. of water three times per day. Selenium 200 micrograms 2-3 three times a day will help in the long run to keep your lungs working better and be sure you get 5-10 mg of zinc a day to insure you have enough of this to help regenerate your tissues. Copper is one of those that in excess can be bad but a little is needed for optimum functioning of the different growth factors that are involved with regeneration.
What happens is that these air tubes gradually increase in diameter due to the pus and become bigger around (larger in diameter) than what is seen in healthy people. Within these now enlarged air tubes are small tiny hair-like projections from the inner walls called cilia which sweep bacteria out of the lungs. As these tubes become wider and larger around, the cilia no longer extend across the tubes diameter which keeps pus from being expelled or coughed out entirely.
To reiterate: Bronchiectasis, bronchitis and COPD are best treated by increasing water intake, taking mucous thinning substances like N-acetylcysteine, using anti-inflammatories like aspirin, and a broad-spectrum antibiotic like tetracycline to suppress the activity of bugs which cannot be entirely eliminated due to the presence of permanent lung damage. Vitamin C stabilizes and helps prevent the degradation of the lung tissues, has anti-allergy effects and can help your bowels move. In addition, using very high-quality air cleaners in your home and especially bedroom can be quite helpful. Some people move to areas with very clean air since polluted air is another contributor to lung deterioration. Also, keeping one’s bowels moving regularly with something like Milk of Magnesia – 1 capful or so per day -- can do a lot of good since constipation puts pressure on the diaphragm and by so doing can cause or exacerbate existing shortness of breath.
To these measures we would recommend taking vitamin C, one or two grams in the morning and one or two grams at noon with 8 oz. of water. There are a number of other supplements like garlic, ginseng, TA-65, Vitamin B6, B5, zinc, vitamins A and D that should also help especially with respect to reducing or even eliminating a cough. Vitamin A is much neglected in this condition and we as physicians would take 100,000 units a day for a month or two if our lungs were bothering us. Then, as they begin to show improvement, we would drop the dose down to 25 to 50,000 units per day. Vitamin A helps heal the inner linings of air-tubes, as well as the skin and intestinal tract.
When a persistent cough stops you should continue most of the supplements with the exception of the antibiotics. Then, at the first sign of a cough and especially if a colored phlegm or sputum is produced, resume taking the prescribed antibiotics. For our patients we prescribe minocycline or doxycline 100 mg daily or azithromycin 250 mg/day as a preventive and tell them to double the dose to one cap twice a day or start to take it at the first sign of an infection so there is no delay in getting treatment underway. Every day that a person struggles with an infection is another day of lung destruction and a worsening of their condition.
There is another condition which is often present or which develops over time in those who take antibiotics long-term and whose immune system is weak or compromised due to age and/or disease: YEAST overgrowth (fungi = mold). This is made worse by eating lots of sugars. alcohol and fruits along with a protracted course of antibiotics (Antibiotics kill off the good bacteria which keep yeast under control). Yeast is difficult to diagnose because most doctors lack experience in using a microscope to identify them in saliva or stool samples. Most doctors can diagnose the condition if a person’s mouth and tongue are white and there are small white curds on the mucous membranes, but if these are not present most MDs or DOs will tell you that you don’t have a fungal infection. Since the antifungal drugs now available are so safe and inexpensive those who suspect they have a fungal infection should urge their doctor to give them a prescription for Diflucan (fluconazole) 200 mg with five refills (and then take one tablet or capsule daily for 2 weeks to start). For those people presenting to their physicians with a cough with discolored phlegm it would be great for them to get a prescription for doxycycline 100 mg (to be taken every 12 hours). Then as the color of the phlegm returns to white the dose of doxycline would be decreased but maintained for 2-3 weeks and then stopped until and if needed again.
It should be noted that the intestines of patients with COPD can contain “microbes” that contribute to their lung problems as well as cause or contribute to a whole host of other chronic problems such as osteoarthritis, autoimmune diseases like rheumatoid arthritis, heart disease, gut diseases like Crohn’s and chronic ulcerative colitis as well as neurodegenerative diseases such as ALS, MS, Parkinson’s, Alzheimer’s plus the one that COPD patients are prone to have, namely vascular dementia.

The methods and tools required to reveal all the organisms present in the gut and what they are doing to us is still very much in its infancy. This is complicated by the fact that the treatment and eradication of toxin producing microorganisms (microbes) can often be extremely difficult due to antibiotic and antifungal drug resistance as well as gut lining “biofilms”. Biofilms appear when is a group of organisms have gathered together and secreted a bunch of sticky goo that holds them together tightly thus preventing antibiotics and antifungals from penetrating and eradicating them.

A health conducive collection or colony of intestinal microorganisms (microbiome) is very important not only to prevent the aforementioned conditions but also for people troubled by immune dysfunction, chronic microbial infections (including candida yeast overgrowth), SIBO (small intestine bacterial overgrowth syndrome), and gastrointestinal issues in general. One consequence of an unhealthy microbiome is a “leaky gut” which allows toxins to enter the bloodstream and be carried to the lungs and other tissues where they wreak havoc. Prebiotics and probiotics such as VSL#3 help remove, replace, repopulate, and repair the gut in these conditions

STEM CELLS

After reviewing the offerings of stem cell clinics around the world, we can categorically state that ours is the only one that pays attention to things like the patient’s gut microbes, heavy metal levels, chronic infections, hormones, growth factors, and oxygen delivery to tissues and organs prior to giving stem cells. One test we recommend that is very inexpensive to do is called a NOCTURNAL OXIMETER TEST. This determines if your body is having episodes of low oxygen at night which is actually very common. When such hypoxic episodes last more than five minutes this will immediately kill any infused stem cells and undermine the entire goal of stem cell therapy both short and long term.

One of the things I (Steenblock) discovered when I was doing a small clinical trial using a patient’s own bone marrow for COPD (something arranged for by Barbara Hanson about 14 years ago) was that many patients who were having to use supplemental oxygen both during the day and night would often have very few stem cells left in their bone marrow because of this chronic lack of oxygen. Oxygen deprivation kills stem cells and especially stem cells on days 10-14 after a stem cell treatment.

Another factor in choosing the types of stem cells and other foods and supplements to optimize treatment outcome is the condition of the person’s heart and kidneys since they can play a significant role in getting them to feel and to do better. If they are diseased and not functioning well these two can prevent an individual from getting a good treatment outcome. For example, a person with an elevated blood ammonia level arising from a poorly functioning liver will have their stem cells killed by the ammonia molecules. And if the kidneys are in chronic failure (CKD=chronic renal disease) then the “small molecular uremic toxins” will kill stem cells as well.

There are in general, three different types of stem cells used at the present time to treat COPD.

1) Fat or adipose stem cells which usually involves inserting a “cannula” into anesthetized belly fat and sucking out anywhere from 10 milliliters to 200 milliliters of it. The more fat that is removed, the more stem cells there are for the doctor to work with.
2) Bone marrow stem cells. These can be a problem since they deteriorate when a person’s oxygen level is low over time. A lack of walking is another reason for the deterioration of the bone marrow. If you are short of breath and can’t walk, a great many of your bone marrow stem cells will deteriorate and die which means your bone marrow has too few stem cells to mobilize into the bloodstream to help heal or repair lung damage.
3) Umbilical cord stem cells. In general, these are the most powerful healing stem cells available but there are problems inherent in using them. First of all, the FDA has not approved these for clinical use (leukemia aside) just like they have not approved fat or adipose stem cells for such use. In addition, there are now at least 20 different small companies that are selling “umbilical cord stem cells” to doctors who actually know very little about stem cells. The umbilical cord stem cells in the vials being sold are few in number (Most vials contain all the cells found in one or two milliliters of umbilical cord blood minus the red blood cells). When a sales rep claims that one million stem cells are present in a vial the actual number is more likely to be 1% of this. Also, almost none of the doctors using these stem cells have even a rudimentary lab nor even a suitable microscope to check on what they are giving their patients (Our clinic has a fully equipped stem cell laboratory on-site and plenty of high power microscopes). This is truly scary. I have had my lab analyze a number of these products and they vary considerably in quality and stem cell count from one lab to another. Some even had such large tissue fragments in them such that when a drop of this material was put on a glass slide my techs and I could see the particles from six feet away! And when we measured these particles, they were up to ¼ inch in diameter which if given intravenously will result in pulmonary emboli when given to patients. Such emboli or blockages can occur with fat stem cells as well since this material has a lot of tissue fragments in it.
4) Bone marrow is legal and in older, inactive people with COPD can be “souped up” to be more active and vital. This is done with bone marrow stimulants and electrical stimulation of the hips and legs which prods the bone marrow to produce new cells.
5) Another type of stem cell we are using but have not tried it in lung cases are stem cells grown from peripheral blood.

There are additional treatment options but for us to legally discuss these readers will have to make an appointment and become a legal patient of ours by filling out some forms and paying one dollar. For cases involving lots of records to comb through we impose a regular new patient charge but then deduct this from the cost of any stem cells that are given. The number to call to learn more is 800-300-1063.

The use of Neupogen (a bone marrow stimulating hormone) prior to a stem cell treatment will help the few stem cells that older and especially chronically diseased people have left in their bone marrow to grow and multiply and become healthier. The addition of this commonly used FDA approved drug will often make the difference between clinical success or failure when using bone marrow as a treatment.

Neupogen is given for five straight days starting two weeks before a bone marrow stem cell treatment or series of treatments. We recommend a two-day procedure where one hip is used to harvest cells on day one and the other hip is used on day two. After bone marrow is given intravenously the stem cells get trapped in the lungs for 24 hours which is a good thing when it comes to COPD.

In our clinic we use bone marrow therapy for other conditions as well but then add umbilical cord stem cells to the iv immediately after the bone marrow has been given. This is because the lungs grab onto the bone marrow stem cells which occupy all the available attachment sites or tissue traps which means that the umbilical cord stem cells (which follow) glide right through the lungs to other organs that need healing. For example, many patients with COPD have heart problems which this method helps get stem cells to.

Umbilical cord stem cells come in different varieties with one very primitive type designated CD34+/CD133+ being used at our clinic. These are, in fact, at least 10 times more powerful than the umbilical cord stem cells others are using. The optimum method of healing old degenerating tissues is by a combination of hematopoietic stem cells (CD34+) and mesenchymal (stromal) cells in a 1 to 6 ratio. In addition, exosomes and VSEL’s (very small embryonic stem cells) and platelet rich plasma can be used to enhance the success of therapies. Nebulization of the stem cells and growth factors has been shown to be helpful in many cases as well.
One question that arises is how our clinic can offer all of these different types of stem cells without getting into hot water with the FDA. When you advertise the use of stem cells for any disease or medical condition the FDA considers this a drug claim and since they have not approved stem cells for clinical use (other than “minimally manipulated” bone marrow and cord blood stem cells for leukemia) we restrict our advertising accordingly. Another fact is that licensed physicians do not fall under the FDA’s jurisdiction when treating their own private patients in their own office or clinic (Technically, the FDA does not govern the practice of medicine.) It is the advertising that gets people into trouble and the claims being made. So here and now we will tell you that everything we offer and have discussed herein is and should be considered RESEARCH only! If you want an FDA approved treatment your conventional doctor Is the person you should be speaking with and you should not be exploring the intricacies of experimental stem cell research!

Of course, most people want to know what kind of stem cells are best for their condition but the answer is that no one knows for sure. With this said, I (Steenblock) know from experience that the more types of stem cells a patient gets, e.g., bone marrow, fat, umbilical cord and peripheral blood stem cells, along with the appropriate lung growth factors and supplements such as N-acetylcysteine, the better the results tend to be.

In general, primitive (i.e., younger) stem cells produce the best clinical responses. And the fact is embryonic stem cells are the most primitive and have the greatest impact on various diseases and conditions. Many of our clinic patients have received embryonic stem cells at clinics outside of the USA which has given us the chance to compare their clinical effects to those of umbilical cord and other stem cells. What we found is that an embryonic stem cell is equivalent to four umbilical cord CD34+/CD133+ stem cells or around 40 CD34+ umbilical cord stem cells, and to about 100 million bone marrow stem cells from a 30-year-old person and approximately 500 million bone marrow cells from a 70+ year old person.

We would be remiss not to say something about intravenous EDTA chelation therapy. This treatment modality removes heavy metals such as lead, mercury, cadmium, arsenic, from the body, usually in the urine, all of which metals can damage and kill infused stem cells. Chelation has been used in the USA since the 1940’s beginning with IV lead removal in a young boy at Georgetown University Hospital in Washington D.C. (which saved his life). At Henry Ford Hospital in Detroit, Michigan, there were other uses discovered for EDTA (a synthetic amino acid) with respect to the treatment of angina, high blood pressure and other cardiovascular conditions in lead battery workers, all of whom improved as the lead was removed from their bodies. As it turns out, their cardiovascular problems were all related to lead which played a role in the U. S. government’s decision to remove lead from gasoline in the 1970’s. Mind you, intravenous EDTA works far better than oral forms, which isn’t surprising in light of the fact that the bioavailability of oral EDTA is about 5% of that of intravenous EDTA. So, for those who like taking pills, mull over having to take 100 EDTA pills (500 mg. each) to produce 2500 mg of EDTA in the bloodstream which is the therapeutic dose in a single IV (given over a 3-hour period). The combination of giving Disodium EDTA prior to the administration of stem cells is being done in our office since the EDTA opens up the capillaries of the lungs and allows stem cells to enter into and repair the tissues better. This can be combined with other materials to help remove old senile cells from the lungs that are no longer capable of repairing themselves and cause more irritation and inflammation as a result of their “Senescence-associated Secretory phenotype”.
There are also benefits for COPD patients to taking CBD oil as this appears to have anti-inflammatory properties, helps to support the immune system, and may have antimicrobial activity as well. There are some recent journal articles which revealed that cannabidiol improves lung function in those with acute lung injury. Readers should check out www.cbdoilbenefits.org and also do a quick google search using “CBD oil and COPD” as a search term.
And, in closing, we would like to point out that our clinic’s Youngering Program offers a combination of treatments that are of benefit to COPD patients:

1. Intravenous chelation with special nutrients such as glutathione to help remove inactive senescent cells (Something referred to in technical parlance as “senolytic therapy”).
2. Intravenous stem cell treatments which replace older inactive senescent cells with newer more active stem cells.
3. Exercise with oxygen therapy (EWOT).
4. External counterpulsation therapy to drive the stem cells into the tissues (EECP).
5. Stem cell bone marrow stimulation to release stem cells into the body and a special stem cell light activator applied to the body to activate newly infused stem cells so that they will rapidly proliferate and grow in the blood stream.
6. Treatment with telomere extenders to rejuvenate the body’s cells and tissues.
7. In light of the fact that the response to stem cell therapy in lung patients varies due to the many variables at play (in their bodies) such as the type & extent of lung disease present, whether there is coexisting heart disease or pulmonary hypertension, heavy metals levels, leaky gut, hormone problems, undiagnosed infections, gum disease, an inadequate or poor diet, use of alcohol, drug interactions, etc., it follows that the odds for improvement are much better if all of these factors are dealt with prior to treatment. Of course, the more cells that are given and the greater their variety helps improve the odds of seeing significant clinical improvements.
8. The use of immunosuppressive drugs (prednisone, cyclosporine, etc.) and alcohol should be avoided for at least one week before and for at least one month (preferably 3 months) after the stem cells.
9. At the clinic, various lab tests are suggested to be done on all new patients to determine which heavy metals are present and in what quantities, as well as tests geared to reveal metabolic issues (organic acids assay) and digestive & stool problems.
10. Based on a patient’s medical history and test outcomes (cited above), we create an individualized diet, supplement, nutraceutical, etc. program which addresses your unique health needs and challenges.